This document summarizes a literature review on the subject from 1985-1999. Research topics addressed in the report include racial disparities in heart disease and stroke, cancer, diabetes, HIV/AIDS, mental health, and maternal and child health. Sentinel articles are identified and tabled in an appendix.

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Toplines

This is a copy of the results of a telephone survey conducted on a random, national sample of nearly 4,000 African American, Latino and white adults, 18 years of age and older. The questions were designed to reveal what each respondent believed about the impact of race and ethnicity on medical care today. Some questions asked about respondents’ experiences and others asked about their perceptions.

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Chart Pack

This chartpack includes a number of figures that are based on the results of the survey on perceptions of, experiences with, and attitudes about racial and ethnic disparities in medical care.

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In an effort to address the racial inequities in health care that exist today, the Kaiser Family Foundation brought together leading public and private sector policymakers — including health professionals, educators, civil rights leaders, and consumer organizations — to review the evidence and race and medical care and discuss what can be done to address inequities in care.

The following materials were released at the October 14, 1999, forum:

• Key Facts: Racial and Ethnic Disparities in Medical Care
• Perceptions of How Race and Ethnic Background Affect Medical Care: Highlights from Focus Groups
• Topline/Survey: Race, Ethnicity and Medical Care: A Survey of Public Perceptions and Experiences
• Chart Pack: Race, Ethnicity and Medical Care: A Survey of Public Perceptions and Experiences

Recent expansions in public health insurance for children and changes in welfare laws present states with the challenge of identifying and enrolling the large population of uninsured children in their Medicaid and Children’s Health Insurance Programs (CHIP). This study describes and analyzes the outreach and enrollment strategies and systems in place in four states at the county level, highlighting issues and challenges states face during implementation. The study sites selected were Santa Clara County (San Jose), California; Bibb County (Macon), Georgia; Cuyahoga County (Cleveland), Ohio; and Bernalillo County (Albuquerque), New Mexico.

Latinos and HIV/AIDS (Spanish version)

This fact sheet provides an overview of the HIV/AIDS epidemic in the United States as it has affected Latinos, including information on the disproportionate impact of HIV/AIDS on the Latino community and a current case profile. It is available in English and Spanish.

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News Release

Americans Willing to Pay for

Improving Schools

Public Approves of Higher Taxes for Schools, but Insists on Fairness in How the Money Is Spent; Support Weak for Vouchers, Unclear for Charter Schools

A new survey on education released today shows that Americans think education is so important they are willing to pay substantially higher taxes for specific improvements. Although parents generally are enthusiastic about their children’s schools, they believe other schools in their community aren’t as good and schools across the nation are even worse. There is strong support across the board for many improvements – from enforcing academic standards to paying teachers more and fixing up rundown schools. But a majority opposes one of the most controversial reform proposals, vouchers. However, the survey indicates vouchers are a volatile issue, with opinions subject to change, and on another controversial reform, charter schools, Americans are even less certain about their opinion. Reports based on the National Public Radio/Kaiser Family Foundation/Kennedy School of Government survey on education will be aired on NPR beginning Tuesday, September 7, 1999.

Key findings include:

Spending and Reform

• The survey identified strong public support for educational reforms, even if it means paying higher taxes. Three out of four Americans say they would be willing to have their taxes raised by at least $200 a year to pay for specific measures to improve community public schools; more than half (55%) say they would be willing to have their taxes raised by $500. Only 16% say they would NOT pay even an additional $100 for this purpose.

• When asked whether states should spend the same amount of money on all students, more than four out of five Americans (83%) support equalizing school funding even if it means taking funding from wealthy school districts and giving it to poor districts. Furthermore, nearly 70% think wealthy districts’ spending should be “capped so that poor districts are not left behind”; fewer than three in 10 (27%) think wealthy school districts should be able to spend as much as they want.

• Americans are divided on school vouchers: 54% oppose vouchers and 42% favor them. However, about half change their position – in both directions – when confronted with arguments against their initial position. This indicates that the debate over vouchers is still an open one. Moreover, 66% of parents of children in public schools say they would not take advantage of a voucher program, even if it paid all the tuition for them to send their child to a different school.

• On public charter schools, another controversial reform, more Americans favor them than oppose them, but 63% say they haven’t heard enough about charter schools to have an opinion about them.

• The public is split over what the underlying purpose of schools should be, but teaching the basics seems to have an edge over other activities. In one question, about half (52%) think schools have gotten too far away from basics, although 41% say that schools need to teach students about a broader range of subjects than they used to because the world is more complex today. In another question, asking which is a more important role for schools, 52% choose giving students academic skills and other knowledge to prepare them for a job or college over developing students’ character so they can make responsible decisions as adults (34%) – but 13% volunteer “both” as an answer to the question.

Education Seen As a Top National Issue

• The public thinks education is one of the top problems facing the country today. While crime is cited as the No. 1 national problem, education and drugs round out the top three. Non-parents (14%) are just as likely as parents (13%) to cite education as their primary concern.

“My School Is OK, But Yours Isn’t”

• Parents give high marks to their children’s schools (71% rate them A or B) but are less enthusiastic about schools in their community (60% rate them A or B) and think even less about the nation’s schools overall (only 23% rate them A or B; 18% give them a D or F). This means that although parents may have underrated the nation’s schools, they clearly tended to overrate their own children’s schools and their community’s schools as well; not everyone can be above average.

• Parents think the nation’s public schools have more serious problems than schools in their local community. The majority of parents named six concerns as major problems facing schools in the nation. But none of these was identified by a majority of parents as major problems in their own community’s schools:

• Undisciplined and disruptive students (71% say it’s major problem in schools nationwide; 40% say it’s a major problem in their community’s schools)
• Lack of parental involvement (68% nationwide; 43% community)
• Overcrowded classrooms (64% nationwide; 44% community)
• Violence and school safety (63% nationwide; 31% community)
• Students’ use of alcohol and drugs (62% nationwide; 44% community)
• Inequality in funding among school districts (54% nationwide; 36% community)

The NPR/Kaiser/Kennedy School Poll is an ongoing project of National Public Radio, the Henry J. Kaiser Family Foundation, and Harvard University’s Kennedy School of Government. Representatives of the three sponsors worked together to develop the survey questionnaire and to analyze the results, with NPR maintaining sole editorial control over its broadcasts on the surveys.

The project team includes:From NPR: Marcus D. Rosenbaum, Special Projects Editor.From the Kaiser Family Foundation: Mollyann Brodie, Vice President, Director of Public Opinion and Media Research; and Ana Maria Arumi, Research Associate.From the Kennedy School: Robert J. Blendon, a Harvard University Professor who holds joint appointments in the School of Public Health and the Kennedy School of Government; and John Benson, Deputy Director for Public Opinion and Health/Social Policy at the Harvard School of Public Health.

Methodology:The results of this survey are based on nationwide telephone interviews administered by ICR/International Communications Research, between June 25 and July 19, 1999, with 1,422 adults, 18 years or older (570 were parents and 852 were non-parents). In this survey, parents are defined as adults who have children in grades K-12. Non-parents are defined as adults who either do not have children or whose children are not in grades K-12. The margin of sampling error is plus or minus 3 percentage points. For results based on subsets of respondents the margin of error is higher.

To order transcripts and tapes of this story and others, please call:Toll-Free 1-877-NPR TEXT (1-877-677-8398)International calls: (+801) 374-1022Or write:NPRc/o Burrelle’s TranscriptsP.O. Box 7Livingston, New Jersey 07039-0007Please include program name, date and subject.

This page and all contents are Copyright

This Background Paper presents information on the disabled population, as well as alternative definitions of disability and the resulting impact on population estimates of the disabled population. In addition, this paper presents a profile of non-elderly persons with disabilities, including work status and health insurance coverage, and concludes with a discussion of policy issues related to facilitating participation in the workforce for persons with disabilities and improving access to health insurance coverage.

Background Paper (.pdf)

This report focuses on Tennessee’s experience in moving their disabled Medicaid beneficiaries into managed care. It is one of a series of reports from The Kaiser/ Commonwealth Low-Income Coverage and Access Project. This project examines how changes in the Medicaid program have affected health insurance coverage and access to care for the low-income population in eight states: California, Florida, Maryland, Minnesota, New York, Oregon, Tennessee and Texas.

Report (.pdf)

This study goes beyond the legislative debates over expanded patients’ rights to explore how managed care consumer protections have actually been implemented in four states (Missouri, New Jersey, Texas & Vermont) all of which have been active in this area. The study describes the details of the reforms, the issues that have arisen in implementation, and the lessons for policymakers from the experiences of these states. The Full Report (document #1518) is available on-line.

• Executive Summary

This report compares Medicare and private health insurance per capita spending between 1970 and 1997, demonstrating that Medicare has done better or as well as the private sector in controlling the growth in health spending. Using National Health Expenditure accounts data, the analysis reveals the cumulative increase in per capita health care spending was lower for Medicare than the private sector between 1970 and 1997. Medicare most likely maintained its cumulative advantage, due to the success of cost-cutting measures implemented in the 1980’s. However, the report suggests that per capita health spending may begin to rise at a faster rate under Medicare than in the private sector because of: (1) the growing role of technology in diagnosing and treating older patients; and (2) the aging of the Medicare population and higher than average Medicare expenditures among the growing, oldest cohort.

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